Figure 185

Protein metabolism in acute renal failure (ARF): activation of protein catabolism. Protein synthesis and degradation rates in acutely uremic and sham-operated rats. The hallmark of metabolic alterations in ARF is activation of protein catabolism with excessive release of amino acids from skeletal muscle and sustained negative nitrogen balance [7, 8]. Not only is protein breakdown accelerated, but there also is defective muscle utilization of amino acids for protein synthesis. In muscle, the maximal rate of insulin-stimulated protein synthesis is depressed by ARF and protein degradation is increased, even in the presence of insulin [9]. (From [8]; with permission.)